How much rates vary
Facilitymedian $1 · 10th to 90th $1 to $42Professionalmedian $1 · 10th to 90th $0 to $1
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $0.62 Median $1.48 Typical High $1.48 | Professional | None | $0.62 | $1.48 | $1.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.31 Median $0.76 Typical High $0.76 | Professional | 52 · Reduced service | $0.31 | $0.76 | $0.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.30 Typical High $0.30 | Professional | 53 · Discontinued | $0.12 | $0.30 | $0.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.22 Typical High $0.22 | Professional | 55 · Aftercare only | $0.09 | $0.22 | $0.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.15 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.06 | $0.15 | $0.15 |
BCBS Idaho Setting Facility Modifier None Typical Low $0.78 Median $1.02 Typical High $1.78 | Facility | None | $0.78 | $1.02 | $1.78 |
BCBS Idaho Setting Professional Modifier None Typical Low $0.78 Median $1.17 Typical High $1.23 | Professional | None | $0.78 | $1.17 | $1.23 |
Cigna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Moda Health Setting Facility Modifier None Typical Low $0.95 Median $1.07 Typical High $1.48 | Facility | None | $0.95 | $1.07 | $1.48 |
Moda Health Setting Professional Modifier None Typical Low $0.62 Median $1.17 Typical High $1.48 | Professional | None | $0.62 | $1.17 | $1.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.31 Median $0.76 Typical High $0.76 | Professional | 52 · Reduced service | $0.31 | $0.76 | $0.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.30 Typical High $0.30 | Professional | 53 · Discontinued | $0.12 | $0.30 | $0.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.22 Typical High $0.22 | Professional | 55 · Aftercare only | $0.09 | $0.22 | $0.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.15 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.06 | $0.15 | $0.15 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1.41 Median $41.69 Typical High $67.61 | Facility | None | $1.41 | $41.69 | $67.61 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1.17 Median $1.41 Typical High $79.43 | Professional | None | $1.17 | $1.41 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.78 Median $0.78 Typical High $1.17 | Professional | None | $0.78 | $0.78 | $1.17 |
Select Health Setting Facility Modifier None Typical Low $1.12 Median $1.12 Typical High $1.45 | Facility | None | $1.12 | $1.12 | $1.45 |
Select Health Setting Professional Modifier None Typical Low $1.12 Median $1.23 Typical High $2.63 | Professional | None | $1.12 | $1.23 | $2.63 |
United Setting Professional Modifier None Typical Low $0.36 Median $0.46 Typical High $0.65 | Professional | None | $0.36 | $0.46 | $0.65 |
1 more rate with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $0.72 Median $0.83 Typical High $0.85 | Professional | 78 · Unplanned return to OR | $0.72 | $0.83 | $0.85 |
Where Idaho sits
The same service costs 2.6 times more in Hawaii than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Idaho· 2nd of 51
$1.17
HI $1.17UT $0.46
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.